Q: Can you speak a little bit about the increasing incidences of melanoma and non-melanoma skin cancers?
The incidences of all skin cancers has increased probably tenfold in the last twenty years or so, for any number of reasons. We think some of it is due to excess sun exposure with inappropriate protection or in some instances no protection at all from the sun. In this part of the world we do not get a huge amount of sun so it is difficult to use this reason as the only reason why we have such an increase. I think it is certainly something to do with the damage that has been caused to the ozone layer and the depletion of the ozone layer results in an absence of protection for our skin in terms of the ultra violet light coming through.
I see differing amounts of skin cancer in different parts of the country. For example, in and around Kilkenny where there is a very big farming community it is hugely evident. My clinics would be replete with farmers who spent all their lives outdoors and they certainly were not using sun lotion on back in the day and will not put it on now. So I think the result of increased incidences of melanoma and non-melanoma skin cancers is a combination of damage to the ozone layer and perhaps an increase in outdoor activities. It may also be in fact that we are recognising skin cancers much more than we did previously. Not a lot of skin cancers are ultimately fatal, they can grow and they cause problems but they do not necessarily cause your demise thankfully.
Q: What are the steps that people can take in terms of vigilance with regards to skincare?
I think vigilance is the key. It is sometimes difficult as we can normally only see around 50% of our body when we look in the mirror so this makes it difficult to keep an eye on our skin. So the first thing is it is probably a good idea to have somebody else keep an eye on your skin, ideally your general practitioner or even a family member or friend. What you really need to look out for is any new skin lesions that you were not born with or any skin lesions that you were born with but that have now changed, i.e. have increased in size, they have become itchy, have started to bleed or darkened in colour. These would be the cardinal signs that we would look for. However if a patient has a concern that something has changed you are probably best off seeing an expert or somebody with an interest in skin, be that a dermatologist or perhaps a GP with an interest in skin or somebody like me.
Thereafter you just need to be aware of your skin. We generally do not think of the skin as an organ but it actually is the biggest organ in the body. Your skin can often change because of holidays and lifestyle and so forth and the lesion changes colour, and that is normal. But a mole that changes colour in isolation is not normal and should be investigated.
Q: What are the main causes of skin cancer?
The short answer is that we do not actually know what the specific cause of skin cancer is. It may be as a consequence of depletion in the ozone layer, as a consequence of lifestyle, i.e. people spending more time exposing themselves to the sun, for example it is now cheaper than ever to afford a sun holiday. However it is probably a combination of decreased natural protection from harmful rays heretofore provided by the ozone layer and excessive sun exposure without taking adequate precautions, be that using appropriate sun protection cream or appropriate clothing.
Q: Are Irish people more at risk of developing skin cancer?
Irish people are more at risk of developing skin cancer because we have less natural protection within our skin. The majority of Irish people are a fair skinned race and because of that we do not have the capacity to absorb harmful sunrays and to manage them appropriately. Whereas a darker skinned person will have more melanin or pigment in their skin and they can therefore absorb sunlight without causing quite so much sun damage. That is not to say that dark skinned people do not get skin cancer, they do, however it is just much more common in pale skinned races where the skin is damaged by harmful sunlight.